Publication:

A comparative study between single incision laparoscopic appendectomy and conventional laparoscopic appendectomy

Background Until recently transumbilical single incision laparoscopic appendectomy has been less popular in clinical practice than traditional laparoscopic appendectomy (LA). The goal of our study was to conduct a comparative analysis of the clinical outcomes for conventional laparoscopic appendectomy (CLA) and transumbilical single incision laparoscopic appendectomy (SILS).

Methods This prospective study SILS versus CLA was carried out in the postgraduate department of surgery GMC Srinagar from February 2013 to October 2014 on patients suspected of having acute appendicitis. All patients were worked up and assessed according to a predefined protocol-detailed history, complete clinical examination, and laboratory parameters.

Results The mean age of the patients in the SILS group was 23.9 years (16-35 years) and that in the CLA group was 25.3 years (16-35 years) (p>0.05). The mean operating time in the SILS group was 57.66 minutes and in the CLA group 52.83 minutes (p>0.05). The difference in the postoperative pain score of the two groups was not statistically significant (p>0.05). In our study cosmesis was assessed by using Manchester scar scale. The mean cosmesis scores were: 7th POD   6.0±0.587 (SILS) and 6.9±0.922 (CLA); 3 months postoperatively 5.73±0.691 (SILS) and 6.56±1.072 (CLA); 6 months postoperatively 5.33±0.606 (SILS) and 6.23±1.104 (CLA). The difference in mean cosmesis score between SILS and CLA was statistically significant (p<0.05).

Conclusions Our comparative study between single incision laparoscopic appendectomy and conventional laparoscopic appendectomy shows that besides better cosmetic results in the former, there are no added advantages. However, SILS can be a safe and feasible alternative in young females who are cosmesis-conscious.